WASHINGTON (NYTIMES) - For almost 40 years, Dr Anthony Fauci has held two jobs.
As director of the National Institute of Allergy and Infectious Diseases, he has run one of the country's premier research institutions. But he has also been an adviser to seven presidents, from Ronald Reagan to, now, Joe Biden, called upon whenever a health crisis looms to brief the administration, address the World Health Organisation, testify before Congress or meet with the news media.
For Dr Fauci, 80, the past year has stood out like no other. As the coronavirus ravaged the country, Dr Fauci's calm counsel and commitment to hard facts endeared him to millions of Americans.
But he also became a villain to millions of others. Trump supporters chanted "Fire Fauci", and the president mused openly about doing so. He was accused of inventing the virus and of being part of a secret cabal with Bill Gates and George Soros to profit from vaccines. His family received death threats.
On Jan 21, appearing in his first press briefing under the Biden administration, Dr Fauci described the "liberating feeling" of once again being able to "get up here and talk about what you know - what the evidence, what the science is - and know that's it, let the science speak."
In an hour-long conversation with The New York Times over the weekend, Dr Fauci described some of the difficulties and the toll of working with former President Donald Trump.
Q: When did you first realise things were going wrong between you and Mr Trump?
A: It coincided very much with the rapid escalation of cases in the northeastern part of the country, particularly the New York metropolitan area. I would try to express the gravity of the situation, and the response of the president was always leaning towards, "Well, it's not that bad, right?" And I would say, "Yes, it is that bad." It was almost a reflex response, trying to coax you to minimise it - not saying, "I want you to minimise it," but, "Oh, really, was it that bad?"
And the other thing that made me really concerned was, it was clear that he was getting input from people who were calling him up - I don't know who, people he knew from business - saying, "Hey, I heard about this drug; isn't it great?" or, "Boy, this convalescent plasma is really phenomenal." And I would try to, you know, calmly explain that you find out if something works by doing an appropriate clinical trial; you get the information; you give it a peer review.
And he'd say, "Oh, no, no, no, no, no, no, no, this stuff really works." He would take just as seriously their opinion - based on no data, just anecdote - that something might really be important. It wasn't just hydroxychloroquine; it was a variety of alternative medicine-type approaches. It was always, "A guy called me up, a friend of mine from blah, blah, blah." That's when my anxiety started to escalate.
Q: Did you have any problems with him in the first three years of his presidency?
A: No. He barely knew who I was. The first time I met him was in September 2019, when they asked me to come down to the White House, bring my white coat and stand there as he signed an executive order regarding something about influenza.
Then, starting in January, February of 2020, it was an intense involvement going down to the White House very, very frequently.
Q: There was a point last February when things changed. Alex Azar was running the White House Coronavirus Task Force, and then suddenly Mike Pence was, and Trump was at the podium taking the questions and arguing with reporters. What happened?
A: To be totally honest with you, I don't know. We were having, you know, the standard kind of scientifically based, public-health-based meetings.
Then I started getting anxious that this was not going in the right direction - the anecdotally driven situations, the minimisation, the president surrounding himself with people saying things that didn't make any scientific sense.
We would say things like, "This is an outbreak. Infectious diseases run their own course unless one does something to intervene." And then he would get up and start talking about, "It's going to go away. It's magical; it's going to disappear."
That's when it became clear to me: I'm not going to proactively go out and volunteer my contradiction of what the president said.
But he would say something that clearly was not correct, and then a reporter would say, "Well, let's hear from Dr Fauci." I would have to get up and say, "No, I'm sorry, I do not think that is the case."
It isn't like I took any pleasure in contradicting the president of the United States. I have a great deal of respect for the office. But I made a decision that I just had to. Otherwise I would be compromising my own integrity and be giving a false message to the world. If I didn't speak up, it would be almost tacit approval that what he was saying was OK.
That's when I started to get into some trouble. The people around him, his inner circle, were quite upset that I would dare publicly contradict the president. That's when we started getting into things I felt were unfortunate and somewhat nefarious - namely, allowing Peter Navarro to write an editorial in USA Today saying I'm wrong on most of the things I say. Or to have the White House press office send out a detailed list of things I said that turned out to be not true - all of which were nonsense because they were all true - the very press office that was making decisions as to whether I can go on a TV show or talk to you.
Q: Were you ever taken to the woodshed? Did anyone say, "Stop disagreeing with the president"?
A: It wasn't that. After a TV interview or a story in a major newspaper, someone senior, like Mark Meadows, would call me up expressing concern that I was going out of my way to contradict the president.
Q: Did Navarro or Dr Scott Atlas, another adviser to the president, or anybody else confront you directly?
A: Oh, no. Peter Navarro, for some strange reason, had a thing about me. He came in one day, and he had a whole list of reprints that were completely nonsense. And he says, "How dare you say that hydroxychloroquine doesn't work? I have 25 papers here that says it works!"
That's when we had a little bit of sharp words in the Situation Room. After that, I said I didn't want to be bothered with him. I don't like to be confronting people. After he wrote that editorial, the papers wanted me to lash back at him. I didn't want to do that.
Q: Did Trump himself ever yell at you or say, "What are you doing contradicting me?"
A: There were a couple of times where I would make a statement that was a pessimistic viewpoint about what direction we were going, and the president would call me up and say, "Hey, why aren't you more positive? You've got to take a positive attitude. Why are you so negativistic? Be more positive."
Q: Did he say why? People were dying. Someone he knew died early on.
A: No. I didn't get into the whys or anything. He would get on the phone and express disappointment in me that I was not being more positive.
Q: He didn't say, "This is killing the stock market," or, "This is killing my chances for reelection"?
A: No, he didn't do that kind of specificity. He just expressed disappointment.
Q: When did the death threats start?
A: Wow. Many, many months ago, in the spring. Hold on - just bear with me. (He consults someone who answers, "March 28.") So there - you got it from the head of my Secret Service detail. That's when I got protection. So maybe two weeks prior to that.
It was the harassment of my wife and particularly my children that upset me more than anything else. They knew where my kids work, where they live. The threats would come directly to my children's phones, directly to my children's homes. How the hell did whoever these assholes were get that information? And there was chatter on the internet, people talking to each other, threatening, saying, "Hey, we got to get rid of this guy. What are we going to do about him? He's hurting the president's chances." You know, that kind of right-wing craziness.
Q: Were you ever shot at or confronted?
A: No, but one day I got a letter in the mail, I opened it up, and a puff of powder came all over my face and my chest.
That was very, very disturbing to me and my wife because it was in my office. So I just looked at it all over me and said, "What do I do?" The security detail was there, and they're very experienced in that. They said, "Don't move. Stay in the room." And they got the hazmat people. So they came. They sprayed me down and all that.
Q: Did they test the powder?
A: Yeah. It was a benign nothing. But it was frightening. My wife and my children were more disturbed than I was. I looked at it somewhat fatalistically. It had to be one of three things: a hoax; or anthrax, which meant I'd have to go on cipro for a month; or if it was ricin, I was dead, so bye-bye.
Q: Was Trump told?
A: I have no idea.
Q: Did you alert anyone around him - as in, "Hey, you're going to get me killed?"
A: No, no. I didn't. Who was I going to tell? What good would it be to tell anyone? Also, it was under FBI investigation, and they don't like you to talk about it.
Q: Did anyone close to Trump ever say, "We were wrong; you were right"?
A: No. No.
Q: Even after he got so sick that he had to be flown to Walter Reed hospital?
Q: Did the president ever ask you for medical advice?
A: No. When he was in Walter Reed and he was getting monoclonal antibodies, he said, "Tony, this really just made a big difference. I feel much, much better. This is really good stuff."
I didn't want to burst his bubble, but I said, "Well, no, this is an N equals 1. You may have been starting to feel better anyway." (In scientific literature, an experiment with just one subject is described as "n = 1.") And he said, "Oh, no, no, no, absolutely not. This stuff is really good. It just completely turned me around." So I figured the better part of valor would be not to argue with him.
Q: Was nobody else advising him, "Hey, maybe we ought to pay attention to the science?" Jared Kushner? Pence?
A: There could have been, behind closed doors, but to my knowledge there was not.
There was one time - we were in the Oval Office sitting in the chairs around the Resolute Desk. We had this interesting relationship, kind of a New York City camaraderie thing where we kind of liked each other in the sense of, "Hey, two guys from New York."
And he was holding forth on some particular intervention and saying something that clearly was not based on any data or evidence. There were a bunch of people there, and he turned to me and said, "Well, Tony, what do you think?" And I said, "You know, I think that's not true at all because I don't see any evidence to make you think that that's the case." And he said, "Oh, well," and then went on to something else.
Then I heard through the grapevine that there were people in the White House who got really surprised, if not offended, that I would dare contradict what the president said in front of everybody. And I was, "Well, he asked me my opinion. What do you want me to say?"
Q: But no confrontation?
A: No, he was fine. To his credit, he didn't get upset at all.
Q: Later he joked with crowds about firing you. How did that make you feel?
A: I thought he wasn't going to do it. I think that's the way he is. People said, "Oh, weren't you horrified that the next day you were going to get a call?" I didn't think at all that he was going to fire me. It was just, you know, Donald Trump being Donald Trump.
Q: But then he brought in Atlas and in effect made him your replacement.
A: Well, Scott Atlas was less a replacement for me than a pushing out of Debbie Birx. My day job is that I'm the director of NIAID. I would go to the White House, sometimes every day during the intense period, but I was considered an outside person. This is a subtlety that people need to understand.
I tried to approach him and say, "Let's sit down and talk because we obviously have some differences." His attitude was that he intensively reviews the literature, we may have differences, but he thinks he's correct. I thought, "OK, fine. I'm not going to invest a lot of time trying to convert this person," and I just went my own way.
But Debbie Birx had to live with this person in the White House every day, so it was much more of a painful situation for her.
Q: Did you ever think about quitting?
A: Never. Never. Nope.
Q: Weren't you concerned that you would be blamed for the failures if you didn't resign?
A: When people just see you standing up there, they sometimes think you're being complicit in the distortions emanating from the stage.
But I felt that if I stepped down, that would leave a void. Someone's got to not be afraid to speak out the truth. They would try to play down real problems and have a little happy talk about how things are OK. And I would always say, "Wait a minute. Hold it, folks. This is serious business."
So there was a joke - a friendly joke, you know - that I was the skunk at the picnic.
Q: Did your wife ever suggest that you quit?
She brought up that I might want to consider it. She's an incredibly wise person, knows me better than anybody else in the world, obviously. She said, "Do you want to have a conversation to balance the pros and the cons of what it would accomplish?" And after a conversation, she ultimately agreed with me.
I always felt that if I did walk away, the skunk at the picnic would no longer be at the picnic. Even if I wasn't very effective in changing everybody's minds, the idea that they knew that nonsense could not be spouted without my pushing back on it, I felt was important.
I think in the big picture, I felt it would be better for the country and better for the cause for me to stay as opposed to walk away.
Q: What are you going to do now? Four more years with Biden?
A: I don't know. Right now I'm not thinking about how many more years. You know, my whole life professionally has been fighting pandemics, from the very early years of HIV, influenza, Ebola, Zika or what have you. This is what I do.
We are living through a historic pandemic, the likes of which we haven't seen in 102 years. I think what I bring to the table is something that's very much value-added.
I want to keep doing it until I see us crushing this outbreak so that people can get back to normality. And even after then, I've left some unfinished business. There's still HIV, to which I've devoted the overwhelming proportion of my professional life.
I want to continue the work that we're doing on influenza, on HIV, on malaria and tuberculosis. As I said, this is what I do.
Q: Let me ask: Do you think Trump cost the country tens or hundreds of thousands of lives?
A: I can't comment on that. People always ask that and … making the direct connection that way, it becomes very damning. I just want to stay away from that. Sorry.